Abstract
Background: Anti-glomerular basement membrane disease (anti-GBM) is a relatively rare entity characterized by antibodies to collagen type IV of glomerular and alveolar basement membranes. The sequential or simultaneous presentation of anti-glomerular basement membrane disease with membranous glomerulonephritis has been infrequently described. Case: We present the case of a 49-year-old man who had fatigue, flank pain, hematuria and renal failure. Serology was positive for anti-GBM antibodies; crescentic glomerulonephritis was seen on renal biopsy. Immunofluorescence and electron microscopy demonstrated evidence of both anti-GBM glomerulonephritis and membranous deposits. Discussion: Simultaneous anti-GBM disease and membranous glomerulonephritis is the most common temporal presentation of this rare entity. However, cases of membranous glomerulonephritis preceding or following recovery from anti-GBM disease have been described. Study of such cases provides insight into pathophysiologic mechanisms, including the possibility of increased antigen synthesis, exposure of cryptic epitopes, and/or capping and shedding of antigen-antibody complexes, in analogy to Heymann nephritis.
Original language | English (US) |
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Pages (from-to) | 120-127 |
Number of pages | 8 |
Journal | Clinical Nephrology |
Volume | 66 |
Issue number | 2 |
DOIs | |
State | Published - Aug 2006 |
Keywords
- Anti-glomerular basement membrane
- Good-pasture's syndrome
- Membranous glomerulonephritis
ASJC Scopus subject areas
- Nephrology